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Most IGF-1 is secreted by the liver and acts as an endocrine hormone, although it can be secreted by many other tissues (162)

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advanced endometriosis is associated with adhesions and altered pelvic anatomy that can impair the movement of oocytes and sperm, induce uterine dysfunction, and prevent normal fertilization and embryonic development

Because many endometriosis patients want both reliable contraception and symptom control, less user-dependent methods often reduce stressespecially if GLP1 side effects are significant